Article

OBJECTIVES: To (1) develop a systems-level quality improvement tool targeting
communicative access to information and decision-making for stroke patients with
language disorders; and (2) evaluate the resulting tool-the Communicative Access
Measures for Stroke (CAMS). DESIGN: Survey development and evaluation was in line
with accepted guidelines and included item generation and reduction, survey
formatting and composition, pretesting, pilot testing, and reliability
assessment. SETTING: Development and evaluation were carried out in hospital and
community agency settings. PARTICIPANTS: The project used a convenience sample of
31 participants for the survey development, and 63 participants for the CAMS
reliability study (broken down into 6 administrators/managers, 32 frontline
staff, 25 participants with aphasia). Eligible participants invited to the
reliability study included individuals from 45 community-based organizations in
Ontario as well as 4400 individuals from communities of practice. INTERVENTIONS:
Not applicable. MAIN OUTCOME MEASURES: Data were analyzed using kappa statistics
and intraclass correlations for each item score on all surveys. RESULTS: A tool,
the CAMS, comprising 3 surveys, was developed for health facilities from the
perspectives of (1) administrators/policymakers, (2) staff/frontline health care
providers, and (3) patients with aphasia (using a communicatively accessible
version). Reliability for items on the CAMS-Administrator and CAMS-Staff surveys
was moderate to high (kappa/intraclass correlation coefficients [ICCs],
.54-1.00). As expected, reliability was lower for the CAMS-Patient survey, with
most items having ICCs between 0.4 and 0.6. CONCLUSIONS: These findings suggest
that CAMS may provide useful quality improvement information for health care
facilities with an interest in improving care for patients with stroke and
aphasia.
CI - Copyright (c) 2017 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS